Audience Needs Assessment

Client Name: / Meeting Planner Name:
Conference Name: / Emergency Phone #:
Conference Location: / Date(s):
Conference Theme / Time of MPK’s Presentation(s):
Estimated Audience Size: / Dress Code:

After you have confirmed Michele as a speaker and completed this form for your event, please send it to , fax to 765.436.7018, or mail to Michele Payn-Knoper,P.O. Box 92, Lebanon, IN 46052 at least one month before your event. Don’t forget to send conference agenda to MPK and review room set-up!

  1. Please provide a brief description of participants (audience mix, education level, leadership position, interests, concerns in business, and training needs)

2. What are your expected outcomes from Michele’s presentation?

3. What do you perceive as the participants’ three greatest needs?

  1. If possible, please list the names and e-mails of three participants for Michele to talk to about their perceptions and needs to develop a better understanding of the audience. This information will not be shared or used for any other purpose.

Name / E-mail
  1. Are there any sensitive issues that Michele should be aware of?
  1. What is it that gives those attending heartburn, concerns, or complaints?
  1. Is there a common conference theme or objective you would like to have reinforced?
  1. Is this an annual meeting or do the attendees know each other? If so, how well?
  1. What is currently happening in your organization that should be applauded?
  1. What are at least three issues or interests that that will appeal to your audience or immediately get their attention?
  1. Do you have any comments from previous program presenters (likes/dislikes)?
  1. What are the names and e-mail addresses of other presenters Michele should include key points from in her program? This is required if Michele is giving a closing keynote!
  1. Do you have any other suggestions to make sure this program is the best ever?
  1. Do you have any plans to have this presentation video or audio recorded? Yes / No

If so, please provide A/V company name and contact info.

  1. Please confirm A/V equipment availability.

Please underline or circle appropriate answer…

Stage/riser (required for audiences over 250 people): Yes / No

Cordless Lavaliere Microphone (primary): Yes / No Handheld Mic (back-up): Yes / No

Flip Chart (workshop) 1 or 2Podium or small table

LCD Projector (workshop) Yes / NoScreen (workshop) size: ______x ______

See AV & Room Set-up under Client Info at for additional logistical information and a helpful meeting planner checklist. Chevron is preferred set-up for keynotes and rounds of 8 or 10 are preferred for workshops.

Please note: Michele requires house sound for all programs and a high speed internet line (not wireless) for any social media workshop.

Thank you for your input. Michele looks forward to energizing your audience and your needs assessment is a valuable tool in her research before your program.

Revised 3/2011